DOC request three complete - Cannabis Defense Coalition

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Bellevue, W A 98005
Phene: (425) 869-6 I 86 .
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www.thc-feundatien.erg-
Documentation of Medical Authorization to Possess
Marijuana 'for Medical Purposes in Washington State
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Patient Name:
Date ofBirth:~
I, Themas Orvald,am a physician licensed in the State efWashingten. I am treating the abeve named
patient fer a terminal illness er a debilitating cQnditien as defined in RCW 69.51 A. 0 10. I have advis'ed the
abeve'named patient about the petential risks and benefits ef the medical use o.f marijuana. I have assessed
t.he above na.T!1ed patient's medical histery and medical cenditien.It is my medical epinien that the petential
benefits ef the medical use ef marijuana weuld likely eutweigh the health risks fer this patient
Signature Of'PhYSician:' ~"-/&~1J;::{'JJd2-!j ~~ ~ .
Thomas O. 'Orvald, M.D. W A # MD 00016180
Today's date: l'October 2008 Expiration date:· . 1 October 2009
Risks and benefits of me.dicaJ marijuana:
Under Washingten state law, the use o.fmedical marijuana is new permissible fer seme patients.with
terminal er debilitating illnesses. The law regulating this (RCW 69.51A) allews physicians to. advise
patients about the risks anci benefits ef the medical use o.f marijuana.
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The medical and scientific evidence supperting the use ef medic,al marijuana remains centreversial in
the medical cemmunity. Net all h'ealth care previders believe that medical marijuana is safe er
effective and some providers feel that it is a dangereus drug. . .
Accerding to. the Washingten state law the benefits ef medical marijuana may include treating nausea
and vemiting frem.chemo.therapy; AIDS ~asting syndrome; severe muscle spasms frem multiple
scleresis er other spasticity diserders; glaucema; and seme types ef intractable pain.
Some ef the risks ef medical marijuana may include po.ssible long-term effects ef the brain in the
areas of memery, co.o.rdinatio.n and cegnitien; impairment o.f the ability to. drive or operate heavy
machinery; respiratory damage; pessible lung cancer; and physical er psychelogical dependence.
Text en this ferm provided by the Washingten State Medical Asseciatien.
PDU-6655-3000318